Coronary artery status of patients with transient fever 24–36 h after first IVIG infusion did not differ from that seen ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Jae Suk Baek, Jeong Jin Yu, Mi Jin Kim, Jihye You, Hyun Ok Jun, Young-Hwue Kim, Jae-Kon Ko

ABSTRACT

BACKGROUND: Current management guidelines for patients with Kawasaki disease (KD) differ in their recommendations for fever observation times when determining resistance to initial intravenous immunoglobulin (IVIG). This retrospective study assessed coronary artery status in patients with transient fever 24-36 h after the completion of a first IVIG infusion. METHODS: Children with KD treated with IVIG between January 2006 and February 2017 were included. Subjects were divided into three groups according to response following the completion of initial IVIG treatment (Group 1, no fever after 24 h; Group 2, transient fever at 24-36 h; Group 3, others). RESULTS: A total of 879 children were evaluated (Group 1, n = 663; Group 2, n = 54; Group 3, n = 162). During the subacute phase, the left main coronary artery (LMCA) diameter z score in both groups was significantly lower than that in Group 3 (Group 1: 1.02, Group 2: 0.87, Group 3: 1.24; Group 1 vs 2, P = 0.298; Group 1 vs 3, P = 0.025; Group 2 vs 3, P = 0.042); similar results were seen with the left anterior descending coronary artery (LAD) diameter z score (Group 1: 0.64, Group 2: 0.38, Group 3: 0.98; Group 1 vs 2, P = 0.083; Group 1 vs 3, P = 0.001; Group 2 vs 3, P = 0.004). The coronary artery (CA) status also did not differ between Groups 1 and 2 during the convalescent phase (z score of LMCA was 0.70 in Group 1 and 0.74 in Group 2, P = 0.790; z score of LAD was 0.42 and 0.46 respectively, P = 0.796; z score of right CA was 0.07 and 0.00 respectively, P = 0.630). A multivariate logistic regression analysis identified total bilirubin level (OR, 2.472; 95% CI, 1.284-4.762; P = 0.007) as the only significant predictor of persisting fever over 36 h in patients with fever 24 h after the completion of initial IVIG. CONCLUSIONS: The CA status of patients with transient fever 24-36 h after the first IVIG infusion did not differ from that seen in responsive patients. More... »

PAGES

83

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12969-018-0301-6

DOI

http://dx.doi.org/10.1186/s12969-018-0301-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110980416

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30594188


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